Semester

Spring

Date of Graduation

2011

Document Type

Dissertation

Degree Type

PhD

College

School of Public Health

Department

Occupational & Environmental Health Sciences

Committee Chair

Cecil M Burchfiel

Abstract

Police officers are a vital part of every community in the U.S. Officers are routinely exposed to numerous types of stressors, including traumatic events, shift work and organizational issues. The impact of this exposure can lead to chronic physical and psychological health problems. Police officers have been reported to have higher rates of cardiovascular disease (CVD). Previous studies have found associations between work stress and CVD, and this association may be mediated by the metabolic syndrome (MetSyn). MetSyn is a clustering of metabolic abnormalities, including abdominal obesity, hypertension, glucose intolerance and dyslipidemia, that has been associated with CVD and Type II diabetes. The goal of this dissertation was to utilize cross-sectional data to determine whether the stressful events of policing and depressive symptomatology were associated with MetSyn, and whether MetSyn was associated with an established and valid measure of subclinical CVD, carotid artery intima media thickness (IMT). In the first study, the association between police stress, as measured by the Spielberger Police Stress Survey, and MetSyn were examined separately in male and female police officers. The multivariate-adjusted number of MetSyn components significantly increased across tertiles of perceived stress and the stress index for the past month in female officers. Police stress was consistently associated with abdominal obesity and reduced high density lipoprotein cholesterol (HDL-C). In the second study, participants included police officers from two geographically separate cohorts, Buffalo NY and Spokane WA. For Spokane men, the multivariate-adjusted number of MetSyn components increased significantly across categories of depressive symptoms, as measured by the Center for Epidemiologic Studies-Depression (CES-D). For each 5-unit increase in CES-D score, the multivariate adjusted odds for having elevated triglycerides increased by 47.6%, by 51.8% for having hypertension, and by 56.7% for having glucose intolerance. The association between MetSyn and carotid IMT was examined in the third study. Among women, the multivariate-adjusted mean common carotid and maximum36 carotid IMT were significantly and positively associated with number of MetSyn components. Carotid IMT was significantly associated with having low HDL cholesterol and hypertension. Given the significant role of police officers in our local communities, it is important to understand the complex relationship between the specific types of police stress and early CVD. Results from these studies will optimize the ability to intervene early before overt disease is present. This may have a greater impact on improving police officers' physical and mental health and decreasing the health consequences of police stress.

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